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Reoccurrence and Confused

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Prostate Cancer
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Posted 8/15/2016 8:54 PM (GMT 0)
6 months ago PSA hit .87 and Dattolli put me back on Advodart. This is slowly bringing it down to .5 now. So now in 3 months if it is not undetectable or if raises I will go back to Sand Laks for a scan.

Cannot do more radiation to the bed and a stretch to find it someplace else. Do I just weight stay on all the new drugs until it catches up or try someplace else.
Posted 8/15/2016 9:45 PM (GMT 0)
Sounds like you go back on the Lupron and see what happens..When that seems to quit working, add Casodex and see what kind of response you get.. When those 3 quit working, move on to Xtandi or Zytiga which can deliver a dramatic response...But NONE of these treatments can deliver a CURE...They just push the inevitable out further, sometimes a LOT further, sometimes not....
Posted 8/15/2016 11:02 PM (GMT 0)
Hope there is something else I could do
Posted 8/15/2016 11:13 PM (GMT 0)
You have exhausted your curative options, but it can be managed for a very long time. Recent evidence is that it is better to start hormone therapy sooner rather than later. And not Avodart - a recent randomized clinical trial showed that doesn't work for the average man when used as part of lifelong ADT

- Allen.
Posted 8/15/2016 11:26 PM (GMT 0)
BTW- It's a good time to find a medical oncologist rather than an RO. It's probably a good idea to get one of the new generation of PET scans, like the one you can get for free at NIH. If you have multiple detectable mets, an early start with Taxotere may be beneficial.

- Allen
Posted 8/15/2016 11:55 PM (GMT 0)
What national hospital has an advanced pet scan?
Posted 8/16/2016 1:50 AM (GMT 0)
What do you mean by "national hospital" - do you mean US government?

NIH has free trials of the F18 DCFBC: /clinicaltrials.gov/ct2/show/NCT02190279

Closer to you, there's a clinical trial of FACBC in Jacksonville FL:
/clinicaltrials.gov/ct2/show/NCT02680041

On the east coast..
I think there will be a new trial of F18 DCFPyL at Johns Hopkins starting soon. Contact Steve Y. Cho.

Memorial Sloan Kettering is testing a good one: /clinicaltrials.gov/ct2/show/NCT02559115

There are more on the west coast at UCSF, Stanford & USC. Also, some places may be selling them outside of clinical trials. You can check if Sylvester offers any.

- Allen
Posted 8/16/2016 1:53 AM (GMT 0)
Thank you. I emailed nih tonight and will contact others tommorrow.
Posted 8/16/2016 2:33 AM (GMT 0)
TA:

Is early taxotere recommended only when mets show up?

Mel
Posted 8/16/2016 8:17 AM (GMT 0)
Mel-

As you know, it's never that simple -- it depends on the specific situation. If you're talking about after a recurrence, STAMPEDE showed it was beneficial after a recurrence when mets were detected. Only 27% of the metastatic men in CHAARTED were recurrent - 73% were originally diagnosed with mets. There was no statistically significant difference in survival among the recurrent men who got docetaxel, only the originally treated men. It also showed that it so far benefitted only those men with multiple mets. We'll have to see if STAMPEDE breaks met volume down in future analyses. Taxotere has been used with modest benefit in a randomized clinical trial of high risk men.
Posted 8/16/2016 2:36 PM (GMT 0)
TA:

You're right. It's never that simple.

But why would it differ between those who are originally dx. with mets and those who developed mets. Seems that would represent the same point in time?

Mel
Posted 8/16/2016 4:43 PM (GMT 0)
I don't know that those represent the same point in development. Keep in mind that statistical significance does not mean that it is ineffective - just that on that sample size, there is wide enough variation across the population that one can't rule out that there was no effect. It is entirely possible that a more highly powered study may demonstrate a statistically significant effect.

- Allen
Posted 8/31/2016 1:11 AM (GMT 0)
Should hear from NRE later this week if accepted for Trial Pet Scan.
Praying that the can find it and nuke it.
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